| NPI | 1093418386 |
|---|---|
| Doing Business As | TLP MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | NICOLE MICHELLE ELLISON Doctor 501-837-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-03-24 |